Provider Demographics
NPI:1184175036
Name:NAJAKA, BRUNO BRIAN IV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:BRIAN
Last Name:NAJAKA
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:NAJAKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:184 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:NANTICOKE
Mailing Address - State:PA
Mailing Address - Zip Code:18634-3715
Mailing Address - Country:US
Mailing Address - Phone:570-479-0811
Mailing Address - Fax:
Practice Address - Street 1:184 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-3715
Practice Address - Country:US
Practice Address - Phone:570-479-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-16
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450772183500000X
PARPI010921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist